Urology malpractice consult: Alleged failure to diagnose, treat abscesses leads to settlement

Acacia Brush Perko, Esq

A 43-year-old woman presented to a local emergency department at approximately 9 AM with complaints of lower back and genital pain since early that morning. A CT scan revealed inflammation of the kidney and a 2-mm kidney stone.

A urologist saw the patient around 3:20 PM and admitted her to the hospital. After midnight, a nurse noted a low oxygen saturation and that the patient was ashen in color. The patient was given 3 liters of oxygen. The medical chart also recorded that her blood pressure had dropped since admittance. Early the next morning, it was noted that the patient’s urine output was low, and her oxygen saturation level continued to drop.

The urologist ordered a chest x-ray, blood gasses, and an electrocardiogram. At approximately 9:30 AM, the patient told the staff she could not breathe. The urologist examined the patient and noted that her color was dusky and that she was in respiratory distress. The patient became unconscious and a code was called. She was in severe respiratory distress and had metabolic acidosis. She was unresponsive to treatment, and blood tests were ordered for sepsis. However, she died at approximately 1 PM. An autopsy determined that she had a kidney infection, which led to septic shock and death.

The patient’s estate brought suit against the hospital nurse and urologist, alleging that the nurse failed to inform any physician of low oxygen saturations and that the urologist failed to diagnose and treat the patient in a timely manner.

The hospital nurse and urologist denied any negligence and claimed they met their respective standards of care. The urologist maintained that as soon as he learned of the patient’s low oxygen saturation and low urine output, he met the standard of care by ordering additional testing. For her part, the nurse claimed it was not necessary to contact the doctor to inform of the low oxygen saturation. A month before trial, the hospital nurse settled for $750,000. The plaintiff’s case against the urologist continued. On the eve of trial, the plaintiff dismissed his case entirely.

Legal perspective: When there are multiple defendants and one settles prior to trial, the remaining defendant has an opportunity to use the “empty chair” defense, in which the defendant tries to convince the jury that a third party is entirely to blame for the plaintiff’s losses. Here, had trial proceeded against the urologist, the empty chair defense would likely have been used.